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P32. Training and education of care professionals

Detailed programme, abstracts and presentations

P32.1. The impact of a dementia service learning project designed for pre-medical students: A Friend for Rachel


1Columbia University Irving Medical Center, New York, United States, 2Eldercare Innovations, LLC, White Plains, United States

With estimates of 50 million cases of Alzheimer’s disease worldwide, the need for good healthcare for people with dementia and their caregivers is essential and must include compassion, support, and appreciation for the multitude of dementia issues. Implemented in 2011, the companion program, A Friend for Rachel (AFFR), was designed to train pre-medical students about dementia and provide them with a sustained relationship with people with dementia in order to foster understanding, decrease stigma, and increase compassion. 101 students from Columbia University participated in the program for at least one academic year. Each student was paired with a person with mild to moderate dementia with whom they spend 3-4 hours weekly exploring New York or chatting in the home. Students were required to attend monthly training sessions about clinical, psychological, and social aspects of dementia; caregiving issues; effective communication skills; dealing with difficult behaviors; use of the arts in dementia. They were also required to submit weekly reflections about meetings with their friends. The goal of the study presented here was to evaluate the impact of the program on the students. Approximately 1200 reflections were read by each author to identify major recurrent themes. These themes were discussed and amended until consensus was reached, and then reanalyze for sub-themes. Five major themes emerged: learnings about dementia, learnings about caregiving, students’ experienced emotions, impact on career choice and learnings about good medicine, and impact on life. The reflections expressed appreciation for dementia’s complex issues and compassion for and comfort with individuals with dementia. The reflections also demonstrated that participation in AFFR caused a reassessment of students’ personal lives and goals. For most students, A Friend for Rachel strengthened commitment to becoming physicians and caused recognition that physicians must have understanding of and empathy for their patients and caregivers.

P32.2. Training and education of care professionals: Dementia Champions

NOONE Archie2, BUCHANAN Marc1, SDWG Members2

1Alzheimer Scotland, Glasgow, United Kingdom, 2SDWG Member, Glasgow, United Kingdom

1Alzheimer Scotland, Glasgow, United Kingdom, 2SDWG Member, Glasgow, United Kingdom

As a collective voice of people living with dementia, the members of the Scottish Dementia Working Group (SDWG) feel that it is vital health and social care professionals learn how to work in partnership with, support and care for people living with dementia.

SDWG have been able to directly influence this by being involved in the development of each of Scotland’s National Dementia Strategies to date.  The current National Dementia Strategy committed ‘to implement national action plans to improve services for people with dementia in acute care and specialist NHS care, strengthening links with activity on delayed discharge, avoidable admissions and inappropriately long stays in hospital’.

This aim is echoed in the SDWG member priority of “Supporting a well-trained workforce”. Central to this has been the groups ongoing support of the national Dementia Champions programme. The programme has been run in partnership between University of West of Scotland and Alzheimer Scotland for the past 8 years and focuses on: improving the care, experience and outcomes for people living with dementia and their families in general hospitals, appropriate discharge and alternatives to hospital care.

To date, the programme has produced over 900 Dementia Champions. SDWG have been a core partner in the implementation of the programme and the knowledge and experience of members have directly influence the education of healthcare staff including nurses, allied health professionals, social workers, Scottish Ambulance Service staff and NHS 24 staff.

Evaluation of the learning experiences of the Dementia Champions clearly evidences improvements in attitudes, confidence and knowledge about working with people with dementia. Importantly, it acknowledged: ‘The input of people with dementia and their families in the Dementia Champions programme provided the strongest and most sustained educational impact on self-definition and the definition of people with dementia by the Dementia Champions.

P32.3. Time for Dementia - A new way of seeing dementia education

DALEY Stephanie1, FEENEY Yvonne2, BANERJEE Sube2

1Sussex Partnership Foundation Trust, Brighton, United Kingdom, 2Brighton and Sussex Medical School, Brighton, United Kingdom

Background and purpose: Inadequate dementia education can lead to a workforce lacking necessary skills, knowledge, and attitudes towards people with dementia. Effectively tailoring dementia education at undergraduate level can prepare the next generation of healthcare professionals to provide high quality, compassionate care.

The Brighton and Sussex Medical School developed the Time for Dementia programme; an innovative approach to dementia education which provides longitudinal contact with families affected by dementia. Students visit a family over a two period, during which families living with dementia share their expert, first-hand knowledge and experiences about the condition with students, helping to shape a new generation of dementia friendly healthcare professionals. 

Methodology: A mixed methods study evaluated the effect of the programme on undergraduate students’ knowledge and attitudes towards dementia and assessed their learning outcomes and satisfaction taking part in the programme. Quantitative outcomes (dementia knowledge, attitudes, and empathy) were collected at baseline, 12 and 24 months for intervention group students (n=274) as well as a control group of students (n=112). Individual qualitative interviews and focus groups were undertaken (n=38 students) at 12 and 24 months as well as satisfaction surveys at 12 and 24 months.

Results: Compared to students who did not participate in Time for Dementia, the quantitative evaluation shows statistically significant improvements in student knowledge and attitudes. Qualitative interviews and focus groups with students have highlighted four key outcomes from the programme: (1) insight and understanding, (2) challenging attitudes and assumptions, (3) relational learning, and (4) enhanced dementia practice.

Discussion and Conclusions: Our research has demonstrated enhancement of knowledge and attitudes towards dementia by putting people affected by the condition at the centre of learning. This has implications for the way dementia education is provided for future healthcare professionals.

P32.4. Maturity of integrated care in primary dementia care networks over time, pitfalls and success factors

OOSTRA Dorien1, HARMSEN Anne1, OLDE RIKKERT Marcel2, PERRY Marieke2

1Radboud UMC, Department of Geriatric Medicine, Nijmegen, Netherlands, 2Radboud UMC, Donders Institute for Brain Cognition and Behaviour; Department of Geriatric Medicine, Nijmegen, Netherlands

Background: An essential strategy to establish a sustainable health care system for people with dementia, is implementing integrated care in the primary setting. To provide knowledge on effective strategies to implement integrated care, deeper understanding of the development of care integration is needed. The aim of this study is to identify the key elements of the development of care integration in primary dementia care networks over time and describe pitfalls and success factors.

Methods: Longitudinal mixed methods study including 18 primary care networks participating in the DementiaNet study, in which a 2-year practice facilitation program was administered. Semi-structured yearly interviews based on the Rainbow Model of Integrated Care were conducted with network leaders. Network maturity scores (range 0-24) were derived from the interview and based on eight integration domains (range 0-3) categorized into three categories: scope (person-focused and population-based), type (clinical, professional, organization and system) and enablers (functional and normative). Scores were determined by two researchers independently. To explain patterns in network maturity, networks were compared based on characteristics and narratives.

Results: Networks consisted of 8 professionals (i.e. median, range 3–48) covering medical, care and welfare disciplines. Follow-up was 2–4 years. Preliminary results based on the first 2 years show an average yearly increase of 2.62 (95%-CI: 1.83-3.40) for total network maturity. All domains showed significant improvement over time (0.23-0.56, respectivelyp=0.003-p=0.000), except system integration. Factors important for improvement include making agreements, knowing each other’s expertise, support from organization and shared leadership. Unfavorable factors include changes in network composition and lack of time.

Conclusion: The DementiaNet program facilitated a clear progress towards more mature primary care networks. Network leadership, commitment and specified goals are important conditions for this progress. Findings provide a better understanding of mechanisms and future improvement strategies for care integration within primary care networks.

P32.5. Learning about dementia care by staff working in acute medical wards: A mixed methods study

SCERRI Anthony1, INNES Anthea2, SCERRI Charles1

1Uni of Malta, Msida, Malta, 2Uni of Salford, Salford, United Kingdom

Aims:To identify the learning needs of staff working in acute medical wards when caring for patients with dementia and how these learning needs can be met.  

Background:Dementia care in hospitals is sub-optimal and challenging. Hospital staff are being trained in dementia care with variable outcomes, although little is known about their learning needs and what strategies can be used to meet them.

Design: Sequential-explanatory mixed-methods study.

Methods: Staff in eleven wards (n=132) completed a questionnaire in May-June 2018, that measured dementia knowledge, attitudes, perceived learning needs and staff perceptions of person-centred care. Two focus groups with charge nurses (n=16) were held in July 2018. Descriptive/inferential statistics analysed the questionnaires whilst thematic analysis was used for the qualitative data. Quantitative findings were explained by interpreting the qualitative data with reference to Argyris/Schon’s organisational learning theory.

Results: Apart from wanting to know more about dealing with challenging behaviours, staff reported the need to learn about geriatric care and team-working. Staff identified different sources that could facilitate learning such as from professionals working in other non-acute settings or from hospital staff who are also informal carers of persons with dementia who would have better dementia knowledge. Staff with better dementia knowledge and attitudes were more critical about the care they delivered. The focus groups provided a tentative explanation– increased awareness through reflection helped participants to question their practice. 

Conclusion: Dementia training of staff working in acute hospital wards is urgently required and their learning needs identified. Dementia training programs need to include organisational learning strategies, such as reflection-on-action, so that staff can move from single-loop to double-loop learning. Improving dementia knowledge through reflection can trigger staff to become more critical of their practice. This study can help educators in developing dementia training programs in acute hospital wards.

P32.6. Leading and Learning: Insights from multiple hospital case study research on staff dementia training

MORBEY Hazel1, HARDING Andrew1, SWARBRICK Caroline1, KEADY John2, AHMED Faraz1, REILLY Siobhan1

1Lancaster University, Lancaster, United Kingdom, 2University of Manchester, Manchester, United Kingdom

Improving the quality of hospital care for people living with dementia is a key priority within European and national dementia strategies. Limited research has evaluated dementia training, especially to understand the relationship between key factors within the context of complex acute hospitals. Furthermore, the involvement of people living with dementia in case study research in this setting is unreported.

The DEMTRAIN study, as part of the Neighbourhoods and Dementia Programme, utilised an organisational case study design to recruit six acute NHS hospitals in England based on a number of factors including: participation in the DEMTRAIN hospital and staff surveys; CQC rating; 2016 National audit of Dementia Organisational Checklist data; patient and staff experience data, and geography. Case study site visits involved data collection from two contrasting wards in each hospital (e.g. elderly care and general surgery), and included qualitative data (focus groups and interviews); environmental checklists, adapted from the Dementia Action Alliance dementia friendly physical environments checklist, and observation of staff activity on wards at shift changeover times, guided by the Huddle Observation Tool. We also facilitated data analysis co-research visits with people living with dementia.

We used a purposive sample strategy to recruit staff at different grades, with different levels of experience, and from different professional groups (including, doctors, nurses, support and domestic staff). 85 staff participated in 12 focus groups and 21 staff in semi-structured interviews. Thematic data analysis included ‘real-time collaborative co-research’ analysis during 5 site visits with people living with dementia and a data analysis workshop with people living with dementia.

Investigation of processes and facilitators involved is key to the development of theory-based dementia training intervention and policies. We present the way in which co-research perspectives influenced analytical interpretations, and outline two key facilitators to hospital dementia training: leadership and experiential learning.



Last Updated: Tuesday 10 December 2019


  • Acknowledgements

    The 29th AE Conference in The Hague received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe and Alzheimer Nederlands gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche